HealthDay News -- More than a fifth of American teens smoke or use tobacco in some way, according to a report in Morbidity and Mortality Weekly Report.

In 2013, 22.9% of high school students and 6.5% of middle school students said they had used a tobacco product within the last month, findings from the CDC's most recent National Youth Tobacco Survey.

Overall, 46% of high school students and 17.7% of middle school students said they had at least tried a tobacco product. More than 12% of high school students said they currently use two or more tobacco products.

Cigarettes were the most common type of tobacco product used by white and Hispanic high school students (14% and 13.4%, respectively), followed by cigars (11.4% and 12.1 %, respectively), the researchers found.

Cigar use among black high school students was nearly 50% higher than cigarette use (14.7% versus 9%), and more than twice as high among black middle school students (4.5% versus 1.7%).

Electronic cigarette use within the last 30 days was reported by 4.5% of high school students and by 1.1% of middle school students.

"Nine out of 10 smokers tried their first cigarette by age 18," Tim McAfee, MD, MPH, director of the CDC's Office on Smoking and Health, said in an agency news release. "We must do more to prevent our youth from using tobacco products, or we will see millions of them suffer and die prematurely as adults."

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